| NPI | 1043473895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: SC 52097) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IL 125-055461) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2022-07-29 |